Objective To systematically evaluate the effectiveness and safety of omalizumab in treating allergic bronchial asthma. Methods The randomized controlled trials (RCTs) about omalizumab in treating allergic bronchial asthma were searched in databases such as MEDILINE, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data from inception to April 2013. The references of included studies and relevant conference proceedings were also retrieved manually. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and assessed the quality, and then RevMan 5.1 software was used for meta-analysis. Results A total of 13 RCTs involving 4 195 patients were included. The results of meta-analysis showed that: a) Compared with the control group, the trial group revealed lower acute exacerbation of asthma during treatment (RR=0.71, 95%CI 0.65 to 0.77, Plt;0.000 01), and higher rate of patients achieved best/better results in Global Evaluation of Treatment Effectiveness (GETE) (RR=1.61, 95%CI 1.32 to 1.97, Plt;0.000 01). More patients could reduce the inhaled cortisteroid (ICS) by 50% during both treatment (RR=1.40, 95%CI 1.29 to 1.52) and 24-week follow-up period (RR=1.69, 95%CI 1.41 to 2.03). And it also increased the ratio of patients whose Asthma Quality Of Life Questionnaire (AQLQ) score got improved by 0.5 and 1.5 socres. b) There were no significant differences in the incidence of overall adverse events (RR=1.01, 95%CI 0.98 to 1.04) and severe adverse events (RR=0.94, 95CI 0.68 to 1.28). c) There might be the effects of omalzumab in improving lung function and reducing rescue medication use, but they were not obviously observed in the studies. Conclusion In the treatment of asthma, omalizumab can decrease the acute exacerbation of asthma and ICS use, and it is safer to improve the therapeutic effects and quality of life.
ObjectiveTo determine the efficacy of omalizumab in patients (12~75 years of age) with severe allergic asthma, and guide its clinical application. MethodsDatabases, including Pubmed, Web of Science and Embase, were searched to collect randomized controlled trials (RCTs).Data were extracted, and the quality of included RCTs was assessed by two reviewers, followed by meta-analyses using Review Manage 5.1 software. ResultsMeta-analyses of ten included RCTs showed that, compared with placebo, omalizumab reduced the rate of exacerbation per patient during both stable-steroid phase [RR=0.56, 95% CI(0.42, 0.75), P < 0.000 1] and steroid-reduction phase for patients with severe asthma [RR=0.53, 95% CI(0.48, 0.60), P < 0.000 01], reduced the number of patients experienced at least one exacerbation [RR=0.71, 95% CI(0.61, 0.84), P < 0.000 01], and significantly reduced the dosage of beclomethasone dipropionate (≥50%) [RR=1.51, 95% CI(1.24, 1.84), P < 0.001].Omalizumab significantly improved asthma-related quality of life [RR=1.25, 95% CI(1.13, 1.38), P < 0.000 01], albeit no indications of omalizumab reducing the rate of emergency visits [RR=0.63, 95% CI(0.28, 1.44), P < 0.001]. ConclusionThe addition of omalizumab to standard asthma therapy reduces asthma exacerbations, decreases inhaled corticosteroid and rescue medication use, and improves the quality of life in severe asthma patients.